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Nursing habits suddenly changed-- what's the problem?

I'm going to a breastfeeding support meeting at the local hospital tomorrow. My 17-day-old daughter's breastfeeding habits suddenly changed this weekend, and it's not working too well for either of us. I wanted to ask you guys if you've had any of these experiences and whether there was a solution, and if there's something I'm missing that I should ask about tomorrow at the support group.

Here's what's going on:

-Big, healthy girl who started latching, feeding, and wetting/dirtying her diapers perfectly from day 1

-My milk came in hard and fast

-She developed thrush in her second week

-Baby is on oral nystatin (side effects can include nausea and diarrhea). I'm using a topical nystatin/triamcinolone cream twice daily and an oral fluconazole tablet once a week

-After a couple of days on the medications, she suddenly became fussy and some of her stools were green and a different texture. Now she grunts and strains and kicks, but without producing a bowel movement--last night she had five runny poops in half an hour and then didn't have any for 12 hours when it picked up green again (wet diapers are still happening frequently)

-At the same time, she stopped latching properly. She sucks the nipple in and spits it out over and over, head-bangs on my breast but won't open her mouth to root for the nipple, sucks in air with every swallow of milk, and falls asleep as soon as the nipple is in her mouth. Then she spits it out and won't take the nipple again--for all of half an hour, when she starts screaming bloody murder and we start the process over. I've started feeding her in reclining and upright positions, and when she quits I burp her and try to get her to latch again or take the other breast, but no luck

So is it most likely too much foremilk? An upset tummy from the nystatin? Both? Or just a fussy baby and I need to tough it out? Or could there be something else going on?

Re: Nursing habits suddenly changed-- what's the problem?

Welcome to the forum and congratulations on the new baby!

What you describe sounds like it could be a combination of fast letdowns and/or reaction to the nystatin. Nystatin might well explain the green poops. But the head-banging, breast refusal, green poops, grunting, and air gulping while nursing all sound like what happens when a baby is struggling to control a rapid milk flow.

I would definitely continue to feed baby in upright or reclined positions, and to be patient; she's only 17 days old and that's just the barest beginning! I would feed baby on demand, or every 2-3 hours, and I would also want to take stock of milk supply at this point, and try to determine if you are seeing any of the following:
- frequent feelings of fullness or engorgement
- lots of leaking
- able to produce multiple oz of milk per pumping session, if you're pumping (which at 2 weeks you should not be, though any women do!)
- baby making gagging, choking, coughing, spluttering, or clicking/clucking noises while nursing

Re: Nursing habits suddenly changed-- what's the problem?

Definitely keep an eye on the oversupply issue as mommal suggested. But I wanted to add that nystatin upset my LOs tummy. And if it's bad enough, thrush can also cause them to feel gassy and uncomfortable.

“We are not put on earth for ourselves, but are placed here for each other. If you are there always for others, then in time of need, someone will be there for you.”
--Anonymous

Re: Nursing habits suddenly changed-- what's the problem?

Thank you! Maybe we're experiencing a perfect storm of discomfort, then. Yes, my milk comes in too fast, and she clicks and sometimes sputters. And no, I'm not pumping yet-- had planned on starting next week, but then the thrush happened and I was going to wait until we'd finished the full course of medication, and now I want to wait until we've got the supply issue under better control.